Reasons Why Patients Failed Vaccinations Vs Influenza and Pneumococcus. Monocentric Cross-Sectional Study

Background/Purpose: immunosuppressive therapies and bDAMRDs expecially, increase the risk of infections. According to the EULAR guidelines, all patients affected by autoimmune/inflammatory diseases should receive vaccinations against influenza and pneumococcus. The primary aim of this work is to evaluate the prevalence of flu and pneumococcal vaccinations in a cohort of patients affected by inflammatory arthritides and SLE treated with biological drugs. The secondary aim was to explore the reason why patients do not receive vaccination. Methods: we administered a self-reporting questionnaire about both flu and pneumococcal vaccination, to 274 consecutive patients from February to April 2017 treated with bDMARDs. Results: the 65.3% of patients declared to have been informed from rheumatologist about the possibility to received vaccinations during biological treatments but the 19.5% declared to have never been informed about them. The 46% of patients vaccination for influenza was performed after rheumatology suggestion and the 21% after their general pratictioner suggestion, while the 30.1% has declared to have not performed it for several reasons: because concerned about adverse events (5.1%), beacause they don’t see it as useful (17.4%) or for other reasons. The injection has been administered for free in the majority of patients (GPs 36.8%, local healthcare 33.5%). The 60.9% would have undergone vaccination even for a fee. The anti pneumococcal vaccination was administered to the 25.3%, while to the 50.3% has never been suggested to do it. The 4.4% has declared to have not performed it because concerned about adverse events and the 6.6% because they don’t see it as useful. The injection has been administered for free at local healthcare facilities in the 84% of the patients. The 97.3% would have undergone vaccination even for a fee. At last the patients have declared to have always been well informed about vaccinations (48,9%), to have been well informed only about certain vaccinations (9,5%) or to have been informed only after asking (9,1%); The 19.1% was unsatisfied. Conclusion: the acquired vaccine rate has been low for the influenza vaccination (<60%) and extremely low for the pneumococcal vaccination (26%). Even if the reasons of this results are partially attributable to a low patients’ compliance (47.5% for the influenza vaccination, 11% for the anti pneumococcical vaccination), almost 20% has declared not to have ever been informed about vaccinations. So an additional effort to improve these results is mandatory.